Pre-knotted loops for surgical purposes consist of suture material and have a slidable knot. They are used in order to ligate freely graspable stumps of a hollow organ or of a bundle of vessels. During endoscopic operations surgical instruments are introduced into the body through trocar sleeves. For such applications an endoscopic loop has proved useful. Such a loop comprises a suture thread formed into a loop having a slidable knot. The free thread portion is guided through an opening provided at the distal face of a thin hollow tube and extends in the interior space of the tube up to its proximal end. There, the loop is fixed to a cap or other kind of handle.
In order to apply the endoscopic loop, first it must be inserted into an auxiliary sleeve which covers the folded loop (including the knot) at its distal portion. After introducing the auxiliary sleeve through the trocar into the abdominal cavity, the auxiliary sleeve is retracted so that the loop becomes accessible. An endoscopic forceps grasps the loop and lays it about the stump. Afterwards the loop is pulled tight by moving the cap or handle in the proximal direction. During this procedure the knot abuts the opening in the distal face of the tube. Finally, the free thread portion is cut using a cutting instrument introduced through another trocar sleeve.
A disadvantage in the application of the known endoscopic loop is that the cutting step is time consuming. Moreover, the surgeon has to be very careful in order to cut just the thread and not to hurt the patient.